You are a salaried professional, and your company provides you group health cover. It seems comprehensive enough, and you think this is sufficient. You are quite content with it, and you believe that in the case of a hospitalization, the group health cover will cover a significant part of your medical expenses. You might even think of cancelling your existing health insurance. Why pay for something the company is providing free of cost? But this could be a big mistake.
There are many reasons why relying solely on the employee group health insurance plan may not be a good idea.
1) Lack of control over coverage amount
The best part of selecting an individual health cover is that you can decide your own health cover amount. But with an employer-provided group cover, this is not always a possibility. Therefore, let’s not get lulled into a sense of comfort by the group health plan. The amount your company fixes is based on your role and rank, and it, most often, does not consider your particular circumstances.
For instance, your employer might think Rs. 3 lakh or Rs. 4 lakh is an adequate amount. While it may actually be enough for a youngster, it would be grossly inadequate for a family of four. You cannot change the coverage amount to suit your requirements, or to account for medical inflation.
2) Job change or job loss leaves you without cover
Another reason you should be looking for health insurance for your family, over and above the employer-provided group health insurance is that your employer’s health cover is active only as long as you are with the employer. It will be gone as soon as you leave the job. What do you do then? This is where individual plans score over group health.
If you decide to switch jobs, you will be bereft of cover until you actually join the new job, and the new company processes your papers. Think of what a sudden illness requiring hospitalization during this interim period will do to your finances!
3) Post-retirement health insurance is difficult to buy
It is most essential to be prepared for the illnesses that may strike when you attain old age. If you depend solely on the employer’s health cover throughout the course of your career, you will have no health cover when you retire. It is very expensive to buy health insurance when you are older in age. In fact, several health insurance plans have a maximum entry age, at 65 years. If you have developed some medical problems, which is more likely to happen than not, your new insurance plan will not cover this condition for at-least 3 years.
4) Company may have different motivation behind providing health cover
Most employers provide health cover not because they are worried about your health, but because they have to in today’s competitive times. And they would like to do it in as economical a manner as possible. To economize, your employer might opt for a plan that just about provides the bare minimum benefit to you. The company, while trying to save on costs of rising premiums, might curtail your benefits.
You need to understand that at the end of the day, providing you health cover is an expense for your employer. Health insurance is just another perk your company gives you; it is not obliged to provide for your best interests. In fact, if the company goes through a turbulent phase, it may withdraw this perk altogether. Where would that leave you?
Although insurers like Apollo Munich offer senior citizen policies, you will still lose out on many benefits which come after a few years of holding an insurance coverage. For example, you’ll have to serve the waiting periods for pre-existing and certain temporarily excluded diseases. This could render the health insurance plan unusable for several years.
5) You might not get to know the terms of coverage
There are many terms and conditions you should know while looking for health cover for yourself and your family. How many of us read the exact terms and conditions of our group health cover? Do we know exactly what we are covered for, and what not? And even if we do take a cursory look at the terms, in case we do not understand anything, how many of us would take the trouble of approaching HR, and seek a clarification?
Yes, lots of questions, but it is very likely that the answer to all of them is a big fat ‘no.' But for own covers at least while buying you are given all kinds of information and documents which you can refer to anytime.
So, let us face it, most of us are not aware of the terms and conditions and the extent of coverage we are being provided by our company. We do not know whether there are any sub-limits or caps on treatment costs. We have no idea what we are being covered for, and yet we are content that the company will provide for us, should anything go wrong with our health!
While it is okay to be grateful that your company is providing you health cover, relying solely on it can be costly, especially as you age. The wise thing to do will be to utilize it as and when you can, and, at the same time, have a separate personal health insurance cover as well.
